Therapy for Problematic Sexual Behavior

In-person and Online Therapy in Minnesota
&
Online Therapy in Vermont

Your sexuality should not cause shame.

Problematic Sexual Behavior is just as it sounds...feeling your sexual behavior(s) have become problematic and feel out of control. And it is a common thing among many people, across all genders and sexual orientations.

You’ve been dealing with problematic sexual behavior for, what feels like, too long; carrying the confusing burden of living a secret life but enjoying it all the same. You are experiencing a constant sense of guilt or shame, worrying about how your behavior affects your relationships with loved ones, yourself, and what it could do to other aspects of your life if people found out. You find yourself hiding your actions, creating a cycle of secrecy and isolation, not sure how to get out, as you swore the last time would be the last time. These behaviors might be starting to impact your work, disrupt your daily routines, and even harm your health. If you have a partner, you might notice increased tension and a lack of intimacy, causing you to feel even more alone.


Maybe you’re noticing frequently:

  • You feel you’ve been living a secret life: You find yourself lying to your partner(s) about your interest or behaviors.

  • Other areas of your life are suffering: You find yourself spending more time than you want, or intend to, on your sexual behavior(s) instead of doing other things (e.g., work, hobbies, spending time with others).

  • You feel ashamed of how you are acting: You are feel strong sense of shame or guilt engaging in, or thinking about, your sexual interests.

  • You’ve tried stopping the behavior before: Despite negative consequences to your personal and/or professional life, you feel like you can’t stop.

  • You feel as if you cannot stop: Despite possible health risks to yourself and your partner(s), you continue to make risky choices.

  • Your mood seems to be all over the place: You cannot seem to focus at work, you feel more on edge with loved ones, you feel worried people will find out, sad that it has gotten this far … it is emotionally exhausting living in secret.

You are able to regain balance within your sexuality.

You have the keys to success already within you to work to identify the underlying triggers and patterns that lead to your problematic behavior, giving you greater control over your actions, freeing you from living that “second life,” hidden from everyone. Rebuilding damaged relationships is also part of your healing process. By fostering open communication and showing a willingness to change, you create deeper connections with those around you. Setting clear boundaries and realistic goals helps you to maintain a balanced and fulfilling life, bringing your sexuality to a place of pleasure and fulfillment, rather than secrecy and shame. As you embrace a new sexual identity that reflects your healthier, more balanced, approach to all forms of intimacy, you begin to experience greater self-acceptance and deeper intimate connections. Developing healthier coping mechanisms—like mindfulness practices, exercise, or other positive outlets—you can find that stress and anxiety become more manageable without resorting to behaviors that feel they create more problems to your problems, rather than solutions.

You no longer have to live this secret life.

By embracing open communication, practicing vulnerability, and understanding the “why” behind your problematic behavior, you can begin to restore intimacy and trust in your relationships and build deeper connections with others. As you set clear boundaries and work toward a more balanced approach to your sexuality, you create space for more fulfilling, meaningful connections, free from guilt and secrecy. This journey requires patience and persistence, but with Jess supporting you, and a commitment to change, you can achieve a healthier and more satisfying life and sexual experiences. You can regain a sense of balance with your sexuality, no longer feeling it is causing you more problems in your life than the brief moments of pleasure.

Individual Therapy for Problematic Sexual Behavior

Using a sex-positive approach in therapy means acknowledging that sexual expression is a natural and important part of your life. By applying the “Problematic Sexual Behavior Model,” you explore the root causes of your behavior without judgment or shame. This approach helps you understand the why behind your actions, focusing on what your sexual behavior might be compensating for or reacting to, such as trauma, attachment wounds, mental health symptoms, or other influences. It encourages you to address these underlying issues while accepting that you can have a healthy and balanced relationship with your sexuality.

Through the "Six Principles of Sexual Health"—consent, non-exploitation, honesty, shared values, mutual pleasure, and protection from STIs and unintended pregnancies—you can learn to embrace a more positive approach to your sexual expression. In individual therapy, you will work with Sex Therapist Jess to understand each of these principles and how they can be applied to your life, allowing you to create your treatment goals, and create a “Sexual Health Plan.”

This process helps you shift from harmful or problematic behaviors to ones that align with your values and respect for yourself and others. By embracing these principles, you build a foundation for healthier, more fulfilling sexual and intimate connections, fostering a sense of confidence and self-acceptance.

Sex Therapist Jess does not come from a “sex addiction” lens.
Problematic Sexual Behavior (PSB) is treated differently from “sex addiction” because it approaches sexual health from a sex-positive perspective, acknowledging that sexual expression is a normal and healthy part of human life, but the secrecy and operating outside of the “Six Principles of Sexual Health” are the problem. While sex addiction often frames the sexual behavior in a negative light, focuses on abstinence and restraint as treatment, PSB emphasizes understanding, exploration, and positive change. PSB seeks to identify underlying issues that may drive unhealthy behaviors, encouraging open communication, consent, and personal responsibility. This approach avoids the stigma and pathologizing often associated with sex addiction, allowing individuals to explore their sexuality in a supportive environment. PSB aims to help individuals develop a balanced and fulfilling relationship with their sexuality, fostering healthy intimate connections and personal growth, and PSB therapists let the client decide what is problematic.

Therapy for problematic sexual behavior can help you:

  • Understand what sexual behavior(s) are typical/atypical and how they have become problematic for you;

  • Begin to remove the secrecy and shame around your sexual behavior(s);

  • Increase your understanding about the “why” of your sexual behavior(s);

  • Increase the understanding of your patterns and begin to interrupt the patterns;

  • Increase your understanding of the “Six Principles of Sexual Health” to rebuild your sexual expressions to things that promote pleasure and intimacy, rather than feel like they take it away;

  • Learn to embrace and accept your sexual attractions, preferences, and creativity and how to incorporate it within your life in a way that is balanced and not hurtful to yourself or your loved ones;

  • Learn how to increase overall intimacy within your life.

You are capable of bringing balance back to your pleasure.

I’m here to help you break free from the secrecy.

FAQs

  • Problematic sexual behavior (also known as “sex addiction,” compulsive sexual behavior, or hypersexuality), refers to a pattern of excessive and, what feels like, uncontrollable sexual thoughts, fantasies, and/or behaviors that interfere with an individual's daily life, relationships, and overall well-being.

  • Treatment for problematic sexual behavior typically involves a combination of therapeutic approaches (such as Cognitive-behavioral therapy (CBT), existential therapy, sex-positivity, or Acceptance and Commitment Therapy (ACT)), medication management (though not always required and this service is not provided by Sex Therapist Jess), and different modes of therapy (e.g., individual and/or group therapy).

    Treatment's primary goal is to help you understand and manage your behaviors by increasing your understanding of why you engage in the behavior(s) (which can involve addressing underlying issues or things that happened in the past that are showing up today), to then understand the “Six Principles of Sexual Health” and how to use these as a guide to developing coping strategies and improve overall well-being and sexual expressions. While Sex Therapist Jess uses a similar modality to treat “Problematic Sexual Behavior,” in terms of the reasons for treatment, there is not "one size fits all,” so she will help you discover the sexual health plan you want for yourself and how to obtain these goals.

  • The exact causes of compulsive sexual behavior are not fully understood, but it is believed to involve a combination of biological, psychological, and social factors. Some potential contributing factors may include a history of trauma or abuse, certain personality traits, underlying mental health conditions (such as impulse control disorders or mood disorders). Sex Therapist Jess will help you to understand what the causes are for you, and how to break free from the hold of the behaviors that are no longer feeling good and/or causing you strain.

  • Treatment for problematic sexual behavior is not a covered code by insurances, as it is not in the DSM-V (which is one reason a lot of sex therapists are out of network providers, including Sex Therapist Jess, except for accepting UCare insurance in Minnesota). Sometimes Jess may use a different (but often related) diagnosis, if one applies for medical treatment necessity.